Healthcare Provider Details

I. General information

NPI: 1437217312
Provider Name (Legal Business Name): DARYLL E. DALEY L AC., MSOM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 W BELMONT AVE UNIT 101E
CHICAGO IL
60618-5933
US

IV. Provider business mailing address

2609 W BELMONT AVE UNIT 101E
CHICAGO IL
60618-5933
US

V. Phone/Fax

Practice location:
  • Phone: 312-810-5538
  • Fax: 773-654-3032
Mailing address:
  • Phone: 312-810-5538
  • Fax: 773-654-3032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198.000634
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: